Medicaid funds repayment mark latest sign of Washington-Tallahassee rift

TALLAHASSEE — The federal government wants to recover $267 million from Florida hospitals it says were paid too much to care for the poor. And it wants the entire amount this year — a demand that is hitting safety-net hospitals like Jackson Memorial in Miami and Tampa General hard.

“Essentially it wipes out any profit we would have next year, so that’s kind of why we’re struggling with it,” said Jackson Health System chief financial officer Mark Knight, noting the state’s largest public hospital had operated in the red for years before turning things around.

Jackson stands to lose $47 million in Medicaid funding with this one issue. Tampa General would be out $13.3 million.

The federal demand is the latest incident highlighting tensions between Washington and Tallahassee over how to provide healthcare to the poor. Republican legislators rejected President Barack Obama’s Medicaid expansion that would have provided health coverage for 764,000 uninsured Floridians.

But Tallahassee leaders wanted to continue receiving $1 billion a year in Medicaid Low Income Pool payments to hospitals. They even asked Washington for more from that program.

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